Detection of Right Ventricular Dysfunction by 2D Strain During Acute Respiratory Distress Syndrom (ARDS)

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT01757522

Acronym

STRAIN

Enrollment

Registered

2012-12-31

Start date

2013-01-03

Completion date

2017-10-25

Last updated

2022-11-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Cor Pulmonale, Acute Respiratory Distress Syndrome, Right Heart Failure, Right Ventricular Dysfunction

Brief summary

Acute respiratory distress syndrome (ARDS) and mechanical ventilation can lead to right ventricular dysfunction and ultimately right ventricular failure by increasing pulmonary vascular resistances and pressure load. This can be prevented by modifying ventilator settings, using vasopressors or inotropes or even by prone positionning.But to do so, right ventricular dysfonction has to be detected. Echocardiography has emerged as a first line tool to diagnose right heart failure. Recently, strain analysis showed promising results to detect early right ventricle abnormalities in other settings such as pulmonary hypertension or scleroderma. We therefore decided to determine whether 2D strain could help detect early right ventricular dysfunction in ARDS.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

ARDS group Inclusion Criteria: * Need for mechanical ventilation * ARDS criteria met: Respiratory failure not fully explained by cardiac failure, Pao2/FiO2\<200, bilateral opacities on Chest imaging, all symptoms appeared within 1 week

Exclusion criteria

* Predictable duration of mechanical ventilation shorter than 48 hours * Contraindication to transesophageal echocardiography ALI group: Inclusion Criteria: * Need for mechanical ventilation * ALI criteria met: Respiratory failure not fully explained by cardiac failure, Pao2/FiO2\<300, bilateral opacities on Chest imaging, all symptoms appeared within 1 week

Design outcomes

Primary

Measure	Time frame	Description
Right ventricle 2D strain	Duration of mechanical ventilation	We will assess whether 2D strain can detect a right ventricular dysfunction as compared to standard echocardiographic parameters

Secondary

Measure	Time frame	Description
Mean right ventricle strain under ventilated patients	at inclusion	We measure right ventricle strain (RV strain) in patients under mechanical ventilation for a non-respiratory cause. This allows us to determine the mean value of RV strain under ventilation when there is no respiratory failure.
Reproducibility between transthoracic and transesophageal strain measures	Time of mechanical ventilation	In ARDS patients, we record a transthoracic and transesophageal echocardiography. We compare RV strain values obtained from transthoracic and transesophageal echocardiography.
NT pro BNP and pre pro endothelin plasma level	At inclusion in ARDS patients	These assays are made based on the hypothesis they could help discriminate between patients who will develop a right ventricular dysfunction from those who will not. A blood sample is withdrawn at the same time as echocardiography only in the ARDS group.

Countries

France

Outcome results